It is “only a matter of time” before a measles outbreak hits Wisconsin, one infectious disease expert said.
Outbreaks are currently raging in New Mexico and Texas, where last week a child died of measles for the first time in 10 years.
“I think given how contagious it is, the fact that there’s this large and growing outbreak in Texas definitely means that spread is possible, if not likely,” University of Wisconsin professor of infectious diseases Nasia Safdar said in an interview. “I mean, these things are only just a plane or car ride away, honestly. So it’s really just a matter of time until we have an outbreak here.”
Epidemiologist and University of Wisconsin professor of population health sciences Ajay Sethi agreed, noting that populations must be 95 percent vaccinated to protect against a widespread outbreak.
Wisconsin Department of Health Services data indicate that 81.6 percent of Wisconsin children had received at least one dose of measles vaccine as of 2021, a figure that Sethi said has not changed meaningfully since.
Waukesha County had the highest vaccination rate at 88.9 percent, while Vernon County in western Wisconsin had the lowest at 52.9 percent.
“We don’t have enough children, in particular, who are vaccinated fully against measles to be able to protect our state and communities from a potential outbreak,” he said. “We just don’t have any county that feels like it’s in a safe spot. It starts with one case.”
That one case can be hard to catch, Sethi said.
“Measles is very infectious,” he said. “You’re actually infectious four days before the rash appears, and the symptoms in those four days before it’s more obvious that one person has measles, the symptoms are just not that specific. They’re flu-like symptoms.”
Measles can be deadly for everyone, but history has shown that outbreaks disproportionately affect communities of color, where access to healthcare and vaccines is often lacking. A 2004 study found that during the last major measles epidemic, in 1989-91, nonwhite children were four to seven times more likely to contract measles than white children. A series of interventions closed a gap in vaccine coverage, and measles was declared eradicated in 2000.
Twenty-five years later, it’s making a comeback, due in large part to a downward trend in vaccination.
“The trend does seem to be for people to not get children vaccinated the way that it was just considered the default state,” Safdar said. “I think that’s the worry.”
Sethi said there’s no reason not to get vaccinated, if you or your children aren’t already.
“It’s never too late,” he said. “I think it’s a great time to (get vaccinated), given we can see what’s happening in Texas, and now there’s a child who died of measles that was 100% preventable.”
What about bird flu?
The other infectious disease on the minds of the experts is H5N1, better known as bird flu. That’s the reason eggs are so expensive, and it’s started to infect mammals, too.
“This broadening of different species that can pick up the virus is concerning because it means it’s just growing and it’s just all around us,” Sethi said.
There is some good news, though. A few people have contracted H5N1, and it’s been a serious illness, but not fatal. And it doesn’t seem to transmit from person to person, at least not yet.
“We’re assuming that the virus hasn’t mutated into a form where (human-to-human transmission) is possible,” Sethi said. “The strain that people have been picking up from cows has not been fatal. … there are a couple strains out there, and the one that has been enumerated the most, there hasn’t been any fatalities, and the strain that has led to a fatality was a different strain.”
The lack of human transition is “a little bit reassuring” to Safdar, but she remains cautious in her optimism.
“When you do get it, it can turn into a very severe condition,” she said. “That’s the concern, that if things were to change, and that (human to human) transition were easier, then it would be a real problem.”
Concern at the federal level
Both Sethi and Safdar expressed concern about the public health implications of recent words and actions by the Trump Administration, where the Health and Human Services Department is led by Robert F. Kennedy, Jr, who has long opposed vaccines and vaccine mandates. He recently said an HHS panel would review childhood vaccine schedules.
“There’s really no debate in the scientific community about the value of vaccines. You know, you only have to go to a region of the world where you don’t have access to a measles vaccine to see the devastation that measles can cause,” Safdar said. “I think anything that interferes with that message to give people the wrong impression about vaccines is concerning.”
Sethi also expressed concern about preparedness for next year’s flu season, as the federal Vaccine and Related Biological Products Advisory Committee’s spring meeting, scheduled for March 13, was abruptly canceled without explanation. At that meeting every year, the committee makes recommendations for the flu strains that will be included in the next flu season’s vaccines.
“The timing is important,” Sethi said. “The expert panel picks a strain. They work with manufacturers, and then just like clockwork, it takes about six months or so to begin producing the vaccine. And then, of course, there’s distribution. And then it gets ready by mid-September. So by canceling that meeting, it’s going to kind of disrupt this process, and it’s unclear what’s going to happen.”
That doesn’t mean there will be no flu shots, necessarily.
“The best case scenario is that vaccine manufacturers can rely on other sources of expert opinion to decide what to include in the vaccine,” Sethi said. “It might be the World Health Organization, it may be other organizations that have access to the data. The problem with canceling the meeting is that it’s unclear if the meeting is postponed, delayed or just dissolved. And because of the uncertainty, everybody’s kind of frozen in place.”
To get your and your family’s vaccines up to date, contact your primary care provider or, if you don’t have one, your local health department. The State of Wisconsin lists websites and contact information for county health departments at this link.
